Splenectomy

A splenectomy is an operation to remove your spleen, which may be necessary for some people living with Inherited Metabolic Disorders. Here, we explain exactly what a splenectomy entails and what life after a splenectomy is like.

What is your spleen?

Your spleen is a fist-sized organ in the upper left part of your abdomen by your stomach and behind your left ribs.

It’s a key part of your immune system, but you can live without it, as the liver can do many of the spleen’s functions instead.

What does your spleen do?

The spleen has some key functions:

  • It combats against invading germs in the blood (the spleen has many infection-fighting white blood cells).
  • It controls the amount of blood cells (white blood cells, red blood cells and platelets).
  • It filters the blood and gets rid of any old or damaged red blood cells.

Spleen problems

If the spleen doesn’t function properly, it can start to get rid of healthy blood cells.

If this starts to happen, it can lead to the following:

  • Anaemia – from a lower number of red blood cells
  • More risk of infection – from a lower number of white blood cells
  • Bleeding or bruising – due to a lower number of platelets

If you’re experiencing spleen pain, you may be able to feel a tender area around and behind your left ribs. If you think that this is something that you’re experiencing, please visit your GP.

Surgery to remove your spleen

If you get to the point of needing your spleen removed, you’ll need a splenectomy, or a partial splenectomy, which is where only half of your spleen is removed.

The majority of operations to remove spleens are carried out using keyhole surgery, also known as a laparoscopy. Keyhole surgery is less invasive but still requires general anaesthetic. Once you’re under general anaesthetic, your doctor will make several small cuts in your stomach. The cuts are used as a starting point to insert the laparoscope into your body. Your doctor will then proceed to remove your spleen partially or fully. Your cuts are then stitched up and depending on your condition, you could be sent home the same day.

Open spleen surgery is only performed when your spleen is too large or damaged to be removed through keyhole surgery. Following open surgery, you could be kept in the hospital for a few days to recover.

Recovery

After your surgery, you’ll feel sore and bruised for some time, but you’ll be given pain relief for this during your recovery. You should be able to eat and drink as normal, but some discomfort may be felt, so take it at your own pace.

Before and after your operation, your doctor will talk you through the possible risks post-surgery. Like any operation, you run the possible risk of infection and/or bleeding. If you do feel like you’re experiencing an infection, contact your GP or hospital immediately, as you could need antibiotics.

Overall, recovery time should take just a few weeks. After recovery, you should be able to resume your normal activities, which your doctor or GP can advise you further about.

Life without a spleen

Once your spleen has been removed and you’re all healed up, other organs, like your liver, can take over many of the same functions that your spleen did. Something that you’ll have to manage for the rest of your life is the chance of infection. While your body should be able to cope with most infections, your chance of a small infection developing into something more serious is increased.

If you suffer from other health conditions that affect your immune system, you’re further at risk. People with health conditions such as sickle cell anaemia, coeliac disease or HIV are most at risk. The risk can be controlled through simple but highly effective precautions such as vaccinations and carrying a ‘I have no functioning spleen’ card, which you’ll be given by your GP after the surgery. If you’re ever taken into hospital again, give the card to a doctor or nurse and they’ll take it from there, making sure the infection risk is kept minimal.

The majority of people who have their spleens removed go on to live normal lives. Of course, there will always be a risk of infection but as long as it’s kept under control and managed, you’ll be able to carry on as normal.

Useful links

NHS

https://www.nhs.uk/conditions/spleen-problems-and-spleen-removal/

Splenectomy Cards

https://www.gov.uk/government/publications/splenectomy-leaflet-and-card

If you would like any further information about splenectomies, please contact us on contact@metabolicsupportuk.org